Millions suffer from Alzheimer’s disease. And, the available and foreseeable treatments are disappointing at best. Given the absence of disease-modifying treatments, there has been growing interest in effective strategies for the prevention of the disease in the first place. Even if we were able to just delay the onset by as little as one year, we could potentially prevent more than nine million cases over the next 40 years.

Once cognitive functions are lost in Alzheimer’s disease patients, they may be lost forever. Consequently, prevention, rather than a cure for Alzheimer’s Disease, appears as a more realistic strategy to offset the catastrophic impact of this dementia.

Considerable evidence now indicates that Alzheimer’s Disease is primarily a vascular disorder, based on a number of lines of evidence that point toward impaired circulation of blood to the brain.

Vascular risk factors, such as high cholesterol, can be thought of as a ticking time bomb to Alzheimer’s Disease. What’s bad for the heart may be bad for the mind.

Traditionally, there have been two competing theories for the cause of Alzheimer’s: the amyloid cascade model that implicates the buildup of amyloid plaques within the brain, and the vascular model, that argues that it is the lack of adequate blood flow to the brain due to atherosclerosis. We now realize they are not mutually exclusive, and that arterial disease can set up a vicious cycle, in which atherosclerotic plaques in the arteries may contribute to Alzheimer’s plaques in the brain.

Although at times portrayed as tantamount to poison, cholesterol is an essential structural component of all of our cells, but if there’s too much, it can become a major factor contributing to various diseases, including coronary heart disease, stroke, and neurodegenerative diseases, like Alzheimer’s. Too much cholesterol in our blood is unanimously recognized to be a risk factor for the development Alzheimer’s disease, and cholesterol may play an active role in the progression of Alzheimer’s as well.

Autopsy studies have found that Alzheimer’s brains have significantly more cholesterol than normal brains, and it specifically appears to accumulate in the Alzheimer brain plaques. We used to think the pool of cholesterol in the brain was separate from the pool we had in our blood, but there is now growing evidence to the contrary. For example, LDL may be able to cross the blood–brain barrier into the brain. So, a high-fat diet may not only increase cholesterol levels in the blood, but also the influx of cholesterol into the central nervous system.

In addition, having high cholesterol may even damage the blood brain barrier itself, and allow for even more cholesterol to flow into the brain, providing the missing link between high cholesterol and Alzheimer’s. Individuals with higher cholesterol levels at midlife have a higher risk of going on to develop Alzheimer’s disease. Cholesterol over 250 could potentially triple the odds of Alzheimer’s.

And now we have high-tech PET scanning of the brain that can directly correlate the amount of so-called bad cholesterol in our blood with the amount of amyloid build up in our brains. You can do it right in a petri dish. Adding cholesterol makes them churn out more the amyloid that makes up Alzheimer plaques, whereas removing cholesterol can decrease the levels of amyloid released from the cells.

In addition, amyloid degradation is less efficient in a high cholesterol environment. Cholesterol can then help seed the clumping of the amyloid. Using an electron microscope, you can see the clustering of amyloid fibers on and around little microcrystals of cholesterol.

Once in the brain, cholesterol can also undergo auto-oxidation, causing the formation of highly toxic free radicals. So, having high cholesterol levels in the blood is thought to increase the risk of dementia, not only by inducing atherosclerosis and impairing blood flow, but they may also directly affect neurodegeneration within the brain. In conclusion, excess dietary cholesterol could, in principle, contribute to the development of Alzheimer’s disease, and the evidence linking high cholesterol to Alzheimer’s appears to be steadily mounting.

Of course, some of this work was paid for by drug companies hoping to capitalize on Alzheimer’s with cholesterol-lowering statin drugs. Ironic, since statins themselves can cause cognitive impairment. Though rare, statin side-effects may include short- and long-term memory loss, behavioral changes, impaired concentration and attention, paranoia, and anxiety, as early as five days after starting the drugs, but sometimes even months later, though folks should recover within a month of stopping the drugs.

A better strategy may be to change the lifestyle factors that lead to the high cholesterol in the first place, in particular, reducing saturated fat in the diet, but it’s not enough for us to just tell our individual patients. Systematic implementation of educational campaigns promoting radical changes in cultural and societal values may be necessary to adopt Alzheimer’s defeating strategies by patients in a broader sense, and such actions “may provide potentially huge dividends by preventing both cardiovascular disease and dementia,” two of our leading causes of death.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Millions suffer from Alzheimer’s disease. And, the available and foreseeable treatments are disappointing at best. Given the absence of disease-modifying treatments, there has been growing interest in effective strategies for the prevention of the disease in the first place. Even if we were able to just delay the onset by as little as one year, we could potentially prevent more than nine million cases over the next 40 years.

Once cognitive functions are lost in Alzheimer’s disease patients, they may be lost forever. Consequently, prevention, rather than a cure for Alzheimer’s Disease, appears as a more realistic strategy to offset the catastrophic impact of this dementia.

Considerable evidence now indicates that Alzheimer’s Disease is primarily a vascular disorder, based on a number of lines of evidence that point toward impaired circulation of blood to the brain.

Vascular risk factors, such as high cholesterol, can be thought of as a ticking time bomb to Alzheimer’s Disease. What’s bad for the heart may be bad for the mind.

Traditionally, there have been two competing theories for the cause of Alzheimer’s: the amyloid cascade model that implicates the buildup of amyloid plaques within the brain, and the vascular model, that argues that it is the lack of adequate blood flow to the brain due to atherosclerosis. We now realize they are not mutually exclusive, and that arterial disease can set up a vicious cycle, in which atherosclerotic plaques in the arteries may contribute to Alzheimer’s plaques in the brain.

Although at times portrayed as tantamount to poison, cholesterol is an essential structural component of all of our cells, but if there’s too much, it can become a major factor contributing to various diseases, including coronary heart disease, stroke, and neurodegenerative diseases, like Alzheimer’s. Too much cholesterol in our blood is unanimously recognized to be a risk factor for the development Alzheimer’s disease, and cholesterol may play an active role in the progression of Alzheimer’s as well.

Autopsy studies have found that Alzheimer’s brains have significantly more cholesterol than normal brains, and it specifically appears to accumulate in the Alzheimer brain plaques. We used to think the pool of cholesterol in the brain was separate from the pool we had in our blood, but there is now growing evidence to the contrary. For example, LDL may be able to cross the blood–brain barrier into the brain. So, a high-fat diet may not only increase cholesterol levels in the blood, but also the influx of cholesterol into the central nervous system.

In addition, having high cholesterol may even damage the blood brain barrier itself, and allow for even more cholesterol to flow into the brain, providing the missing link between high cholesterol and Alzheimer’s. Individuals with higher cholesterol levels at midlife have a higher risk of going on to develop Alzheimer’s disease. Cholesterol over 250 could potentially triple the odds of Alzheimer’s.

And now we have high-tech PET scanning of the brain that can directly correlate the amount of so-called bad cholesterol in our blood with the amount of amyloid build up in our brains. You can do it right in a petri dish. Adding cholesterol makes them churn out more the amyloid that makes up Alzheimer plaques, whereas removing cholesterol can decrease the levels of amyloid released from the cells.

In addition, amyloid degradation is less efficient in a high cholesterol environment. Cholesterol can then help seed the clumping of the amyloid. Using an electron microscope, you can see the clustering of amyloid fibers on and around little microcrystals of cholesterol.

Once in the brain, cholesterol can also undergo auto-oxidation, causing the formation of highly toxic free radicals. So, having high cholesterol levels in the blood is thought to increase the risk of dementia, not only by inducing atherosclerosis and impairing blood flow, but they may also directly affect neurodegeneration within the brain. In conclusion, excess dietary cholesterol could, in principle, contribute to the development of Alzheimer’s disease, and the evidence linking high cholesterol to Alzheimer’s appears to be steadily mounting.

Of course, some of this work was paid for by drug companies hoping to capitalize on Alzheimer’s with cholesterol-lowering statin drugs. Ironic, since statins themselves can cause cognitive impairment. Though rare, statin side-effects may include short- and long-term memory loss, behavioral changes, impaired concentration and attention, paranoia, and anxiety, as early as five days after starting the drugs, but sometimes even months later, though folks should recover within a month of stopping the drugs.

A better strategy may be to change the lifestyle factors that lead to the high cholesterol in the first place, in particular, reducing saturated fat in the diet, but it’s not enough for us to just tell our individual patients. Systematic implementation of educational campaigns promoting radical changes in cultural and societal values may be necessary to adopt Alzheimer’s defeating strategies by patients in a broader sense, and such actions “may provide potentially huge dividends by preventing both cardiovascular disease and dementia,” two of our leading causes of death.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

181 responses to “Cholesterol & Alzheimer’s Disease”

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Systematic implication won’t happen until the stranglehold of the companies over gov’t is broken.

It has to come from us, the people-shame so many more will to die prematurely and demented.

I think I saw some numbers this morning where USC voted overwhelmingly to REMOVE country of origin information from Meat products. This will pave the way for high-intensity meat manufacturing to find the absolute lowest costs in labor and in overhead, kicking the SUPER BUG disease making capacity of that system into overdrive.

Agree about the amazing connection it seems so simple yet so hard for many to grasp! And then the whole debate on coconut oil, which Dr. Greger addresses in his video Does Coconut Oil Cure Alzheimer’s?

If there was one oil you think is maybe safe (or least harmful) to sauté veggies with, what would it be? Organic canola oil or organic first pressed and cold pressed extra virgin olive oil? I know what Dr. G says as far as avoiding oils, as well as Mcdougall and camp. But sometimes some sautéed veggies in oil is a nice treat. I hear so much negative stuff about canola, as far as being unhealthy when heated above certain temps.

Huge difference. The canola is labeled high heat, but it’s not. The PUFAs are not heat stable and should be kept in the dark, refrigerated and should not be used for cooking. The canola oil is 29% PUFA, whereas the sunflower oil I use is 4% PUFA. But, I wouldn’t even use the canola for salad dressing because I keep my TOTAL omega-6 intake below 6g per day and using canola would make that impossible.

Hi Mary, I know there’s GMO problem with Canola oil, but I thought David and I were talking about the Spectrum organic canola vs their organic high-oleic sunflower, so the reason I didn’t mention it is that according to Spectrum, “Spectrum uses no GE canola whatsoever.” (GE = genetically engineered”) – http://www.spectrumorganics.com/faqs/cooking-oils/

That said, I also didn’t mention it because whether or not GMOs are safe is still controversial. But the case is against PUFAs in cooking is iron-clad. So there is no need to even bring up the GMO issue.

This is not to deny your point: I personally avoid GMOs for the health of myself and my family, as well as the health of the biosphere. Genes will never stay put. According to wiki, these genes have already escaped our control: “Roundup canola has also emerged as a weed in other crops due to its glyphosate resistance”

This doesn’t answer your questions regarding oils, but it may be of interest to those who feel like they cannot cook without oil.

Many veggies can be sauteed without oil at all. Those that come to mind are mushrooms, peppers, onions, and the like. You have to pay attention and maybe change your heat/learn to add a splash of water now and then for steam. But it’s not difficult. When i use oil (because I prefer to cook with cast iron), I only wet the skillet and wipe most of the oil away. I can make hash browns every day for a week and keep my oil consumption under a teaspoon-for the week. At that level of consumption, I don’t find any reason to concern myself with the “features” of the oils.

Watching the video I was thinking about the same thing as you do. Don’t the “Grain Brain” crowd and the “Wheat Belly” crowd believe in the opposite, that Alzheimer’s is caused by cholesterol efficiency? Where do they get their data from?

I think their belief is that grains, especially milled into flour, and sugar, are highly glycemic. This puts a strain onto the diabetes issue. They have some data linking high glycemic problems with cardiovascular and Alzheimer’s. Wheat Belly is pretty out there. I think the main problem with Grain Brain is that Perlmutter actually tells people to have more vegetables on their plate than meat or fat and they should only eat free range organic animal products. They are more expensive so people eat the cheap CAFO meat and fat and forego the vegetables. Presto! You have Atkins all over again. Unfortunately people can delude themselves into pretending to be healthy. John S

The contention is that beyond the people who have outright celiac disease, many more a low level gluten intolerance. The idea is that this then sets the stage for chronic disease. This may or may not be true. However, what really sets me off about Perlmutter is his claim that the healthiest diet is 85% fat. I’ve been checking his references on that and as far as I’ve been able to determine, he pulled that number out of someone’s @ss, because he has absolutely no support for it in the references he cites.

Many diseases (and trauma) cause cholesterol to decline. Alzheimer’s is one of this them. Consequently, there is a correlation between Alzheimer’s and low cholesterol. It is also the reason why there is a correlation between low cholesterol and mortality in many population studies.

Julie, I’ve been reading the Perlmutter Grain Brain book and checking his references and I am simply astounded by the number of times he has broken links and/or misrepresents or misinterprets the studies. My feeling at the moment towards him is anger. I had intended to do it to the whole book, but at only 1/3 of the way thru, it seems pointless because I have yet to find a single convincing study to back him up.

Yes Daniel, I have run across the same problem. Although I haven’t checked as many studies as you have, I’ve noticed that the references Dr. Perlmutter uses tend to have little resemblance to the point he’s making.

I had found that article back in September — after becoming frustrated with trying to verify Perlmutter’s claims.

But, you say, “That doesn’t happen with Dr Greger.”, and I can only partially agree. Although Greger is far, far more trustworthy than Perlmutter (to even mention them in the same sentence seems ludicrous), he is by no means perfect. I find claims in his videos for which citations cannot be found and when I ask for them, I’ve yet to see them produced. Also, far too often, I find Greger exaggerating the significance of results or otherwise not reporting studies with complete honesty.

That said, make no mistake, Greger (along with Plant Positive) are my favorite internet sources for nutrition information!

Daniel, in regards to “I find claims in his videos for which citations cannot be found”. This does occur sometimes, I know of a few instances. This is only because the study was not added to the sources cited section on accident. A helpful tip I recommend when this happens is to put in the quoted text into google with quotation marks around it. The study will usually pull up. If you find this problem please let us know, we will make the necessary changes to the sources cited section.

Also, in the May 12, 2014 video, “Debunking Egg Industry Myths”, at 1:05 a graph is presented showing a year in the life of a study subject, on and off eggs. I have been unable to find the source for that one either.

Neurosurgeons who treat patients successfully for movement disorders and brain issues may know a thing or two about how to prevent and treat. Amyloid plaques seem to appear from inflammatory response and other metabolic disorders.

Many diseases (and trauma) cause cholesterol to decline. Alzheimer’s is one of this them. Consequently, there is a correlation between Alzheimer’s and low cholesterol. It is also the reason why there is a correlation between low cholesterol and mortality in many population studies.

Does a single meal of high cholesterol food instantly cause the damage, or are you referring only to a steady high level of cholesterol in the blood, day by day? I am wondering if cholesterol blood levels can drastically spike up within hours of eating, say, an egg and cheese omelette, but by later in the day the blood levels are brought back down, same with levels in the brain? Sort of like how blood sugar works…..rising after eating some carbs/food but blood sugar comes down to base level within hours.

Maybe people who do not digest high cholesterol foods well are having it enter into the brain, damaging blood brain barrier?

I think that is the scary thing in general. While inflammation can be reduced through eating a bunch of berries after eating that high meat based meal that doesn’t remove the cholesterol that will be hurting you. The risk added is just crazy, especially since the risks are just not talked about enough.

” In all subjects, the protocol was repeated on the same day, 6 hours after they had consumed an OFL consisting of 680 kcal/m2 of body surface with 83% fat, 5%proteins, 12% carbohydrates, and 600 mg cholesterol over a 20-
minute time interval”

I think what I am getting at is that I am wondering if one high cholesterol meal could be a causative factor in some people w/ alzhemimers. A meal can be high in cholesterol but not high in fat, Joseph. This is what I was referring to. You have mentioned a link regarding high fat meals. I can see the high fat issue as it regards to the link, but I do wonder about low fat meals that still contain cholesterol as a causative factor in alzh. It seems to be that there is likely another component in the people who fall victim to this as a causative factor. Do we see sky high rates of serum cholesterol readings in the cultures (long lived) who still included animal products? No. But when they ate/eat animal products they likely were also eating it with nutritious foods from the plant family. And history has shown they had great health, and I do not see any big time cholesterol issues. Maybe including junk food SAD (often high in plant-based saturated fats) diet with the animal products is a larger causative factor?

Hi Leslie, I think I know enough about this to take a stab at answering.

Back in 2014, on my birthday, I celebrated with a New York steak and hot fudge sundae for dessert. Now, what you have to know about me to understand this is that I have the e4 allele of APOE, so that put’s me at substantially higher Alzheimer’s and my ability to clear cholesterol is compromised relative to those with the e3 and e2 alleles. Additionally, I have not eaten prudently for most of my life and so, I am a third generation diabetic. I have been tracking my lipids and my blood sugars for years. That because I control my serum cholesterol and blood sugar entirely by diet, exercise and other lifestyle adjustments.

So, in the three months prior to that one meal, my fasting blood sugars had been very well controlled, all below 95, averaging about 85. Likewise, my one-hour after meal blood sugars were so good, I thought I could have that one meal and the fat in it would control my blood sugar and I’d be fine. Well, I was right about the after-meal blood sugar; it was fine. But the meal did something that elevated my fasting blood sugar the next morning to 107. And it was still high the next day, not returning to normal for an entire week.

I don’t do that anymore. High fats, esp sat fat, are known to induce insulin resistance and high free fatty acids will damage your pancreatic beta cells, just as much as does high serum glucose. And damage to your beta cells means they can’t produce insulin when you need it. The Alzheimer’s connection is that high blood sugar levels are just as damaging to the brain as they are to the body.

I used to eat a paleo diet. But I stopped that because it was allowing my fasting glucose to creep up. I switched to a very high fiber WFPB diet and voila! for the first time in my life, my blood sugars and cholesterol numbers are perfect. BTW, I’m 71.

Hey, thank you for that reply and your explanation. I am wondering if you feel that the main problem was with the high amount of saturated fat in your paleo diet, rather than the high amount of cholesterol in some paleo diets. – one can eat low saturated fat and still eat a decent amount of shellfish, therefore ingesting a large amount of cholesterol but not so on the saturated fat.

Something I find interesting is that when I eat avocados, my fasting blood sugars are higher the next day, and when I then eat carbs my blood sugar goes up higher, and faster, than it had been.

> I am wondering if you feel that the main problem was with the high amount of saturated fat in your paleo diet, rather than the high amount of cholesterol

When I was doing paleo, I found that when I went above 50% fat, due to being an apoe4, my TC shot up over 300. So at that point, I tried cutting back on sat fat. I never did have a very high cholesterol intake, because when I eat it, my body can’t seem to get rid of it, so I always kept my cholesterol intake at or below about 125 mg/day. The more I cut back on sat fat (from 22g / day to under 10), the better my serum cholesterol and fasting glucose numbers got.

I never did risk shellfish. I can tell you that once I did eliminate all cholesterol from my diet except a little bit of fish and got my sat fat down under 9 is when my serum lipids, FBG and PP BG numbers came completely down and have been getting better with each lab report, now at:

av FBG: 75
PP BG: never more than 130
TC: 165
HDL: 71

LDL: 84

TG: 49

The trick is that when you eat a very high fiber diet, your gut microbiome converts fiber to very short chain fatty acids and so you can get extra calories into your diet without paying a metabolic price for them.

> when I eat avocados, my fasting blood sugars are higher the next day, and when I then eat carbs my blood sugar goes up higher, and faster

Hi Daniel,
I love the good news of your improved numbers through diet. I have high LDL with small dense particle size. Even when I have no meat ( or rarely), my ldl is over 100. Out of fear ( I have apo e3/4) I started taking 40 mg atorvastatin daily and lost my short term memory. Now doc wants me to take 20 mg a day and I’m afraid the cognitive decline will be so gradual I won’t notice when it is happening this time.
I’m trying to figure out what I’m doing wrong. Do you ever eat nuts? Do you ever have anything sweet? Even exercising most days only helped my prediabetes go away. But I’m so skinny that I don’t care for the look. I don’t eat the big salad every day. Is that critical for success? I may post this for all to see in case not many see this posted on an older video.

> Do we see sky high rates of serum cholesterol readings in the cultures (long lived) who still included animal products?

Leslie, you’re missing a number of important factors. Serum cholesterol levels are multifactorial. Other factors – to mention a few – include:
1) the garbage and antibiotics that are pumped into factory farmed animals
2) primitive cultures did not and continue to not engage in chronic overnutrition
3) ancestral diets don’t always include plant based foods – for instance the Maasai
4) ancestral lifestyles often included massive exercise – something like 20km/day for the Maasai
5) now just emerging, ancestral populations have radically different microbiomes
6) parasite load among ancestral populations helped reduce cholesterol
7) ubiquitous exposure to endocrine disruptors in the industrialized world

If you want to consider the possibility of long life in this modern day world, you would do well to look to the blue zones where they eat low fat plant based diets.

when we talk to keep cholesterol under 150 we mean total cholesterol right? so what is the minimum total cholesterol recommendation? i know person that have 30 of total cholesterol and they were advised to eat eggs..
witch is the write amount of good cholesterol?

While the general impression I get from the doctors here is that there is no minimal level, there are nunerous problems with liw cholesterol. My total dropped below 100 as a result of a very rare drug side effect. Virtually the entire drop was in LDL. As your sex hormones use LDL cholesterol as a raw material, my testosterone plummeted from high for my age to below “normal” (ha!) range at one point. I partially recovered after getting off the drug and adding coconut oil to my diet. I seldom see anyone discussing a low cholesterol number also getting hormone tests but it seems prudent.

I believe the current consensus is that the human body make all the cholesterol it requires, and no dietary cholesterol is needed for healthy function. There is no minimum RDA for cholesterol, only a maximum. As far as SF is concerned, all whole foods have some SF, although it does concentrate as one goes up the food chain so if you eat animal products, you are also getting the accumulated SF that they did not burn off as energy or use to create hormones. There is not RDA for saturated fats, and the best way to minimize the consumption of SF’s is by eating a WFPB diet.

also i wonder in people that have a dysfunction to produce their own cholesterol people that the total cholesterol for some reason drop until 30
do they still not have to eat any dietary cholesterol or saturate fat?

i agree that the general guidelines is to avoid cholesterol it is the best for 9o% of the population for many many health reason but what about this small group of people with a very low cholesterol levels

Hey Noe are you referring to this video about low cholesterol? I see the confusion it looks like those studies are using prospective studies and not clinical intervention studies to measure the associated risk. I would also suggest finding the sources cited and reading the studies Dr. Greger has it may help a bit. If you remember this video he talks about how saturated fat studies are set up to fail.

no doubt that can be made up this kind of prospective study, but it will be good to read the actual studies use in this compilation and confirm of not that they are made up . if we just don’t believe or believe one study or other according to ones own thought it will be good to confirm that low levels of cholesterol does nos increase the risk of stroke with the best science available as you do every day here.

Noe: In addition to the great responses you have received already, I thought you might appreciate the following response which Rami wrote to someone else some time ago, addressing a similar question:

“Cholesterol can be as low as the 10 range and you will still live a perfectly healthy life. This is evident in those who have genetic disorders resulting in extremely low cholesterol, thus, the argument that below 150 is too low is simply untrue. I would see this video for the evidence.http://plantpositive.com/22-cholesterol-confusion-5-cho/
“

I looked at Chris Kresser’s site and work years ago when he was working to get his certificate in some form health counselor. I feel he’s sincere but misguided and misinformed. I would not go by anything he says.

and last question.. most of my family it have obesity but they have low levels of total cholesterol like 130.. i wonder if the Lipids of their overweight may affect or arrive to the brain in the old age and impair cognitive functions as cholesterol LDL seems to do.

I know many who are catagorized as obese, and it has been in the family for generations. Insulin resistance and diabetes follows.
The incredible thing is that the don’t eat much for processed foods! Nobody wants to believe that, though I believe it to be true.
One family member is now almost starving themselves (which never helps) with no results.
Ive seem others who have had to get extreme cardio workouts and no processed foods along with the reduction of fruits and veggies. Counterintuitive.
Diane Kress has great information in her books on how all of that works out.
Meanwhile…they keep pushing the high meat and fat consumption here at the local gym!

Quite possibly but I don’t think there is any definitive answer to your question. What causes the obesity might also cause the increased dementia risk, for example. However, several mechanisms have been hypothesised to explain how obesity might increase dementia risk:
“Mechanistic pathways such as adipocyte secreted proteins and hormones, and inflammatory cytokines could explain the association between obesity and increased risk of dementia.”http://www.eurekaselect.com/77999/article

It is also believed that obesity in and of itself changes our metabolic system and this might well have consequential effects on both cardiovascular and brain health…
“Multiple mechanisms likely contribute to the altered plasma lipid responses to dietary changes in individuals with excess adiposity. The greater rate of hepatic cholesterol synthesis in obese individuals suppresses the expression of hepatic LDL receptors (LDLR), thereby reducing hepatic LDL uptake. Insulin resistance develops as a result of adipose-tissue induced inflammation, causing significant changes in enzymes necessary for normal lipid metabolism. In addition, the LDLR-mediated uptake in obesity is attenuated by alterations in neuroendocrine regulation of hormonal secretions (e.g. growth hormone, thyroid hormone, and cortisol) as well as the unique gut microbiota, the latter of which appears to affect lipid absorption”http://advances.nutrition.org/content/2/3/261.full

Thank you so much for your work! You do such an amazing job of pulling all the research together which helps me so much as a physician. We in the medical community can never thank you enough please don’t ever stop what you’re doing. You are undoubtedly one of the most valuable physicians in the medicalCommunity and world for educating us on the healthiest of lifestyles. Keep up the great work!

Thank you for your kind words. ;-) I can assure you, however, that not every patient feels that way but that is OK. I try to help everyone, but the ones that appreciate me the most are the ones that understand I am a patient advocate first and I have their best interest at heart. Dr. Greger and his team at NutritionFacts.org make that a much easier endeavor.

Just so you know I will be speaking at Healthy lifestyle Expo in Valencia this next weekend, Sat. the 16th, thanks to Jeff Novick and Jeff Nelson and my talk is how I try to implement Plant Based lifestyles changes in my real world medical practice. Maybe you can make it? If not as always thank you for your support! You are an invaluable resource here as well! http://www.healthylifestyleexpo.com/

Joseph. It doesn’t seem that everybody agrees that very low cholesterol level is always the way to go. Here is just one example of many that I have come across:

“Dr. David L. Tirschwell reported to the American Heart Association in 1999 that people with cholesterol under 180 had twice the risk of strokes caused by bleeding into the brain as those with cholesterol counts around 230. The idea that low cholesterol levels could increase the hazard of a devastating hemorrhagic stroke doubtless came as a shock to many cardiologists and neurologists who believe you can’t have too low a golf score or cholesterol level.” I believe this is taken from a book called: Best Choices From The People’s Pharmacy.

I may agree about the low golf score ;-) Yes, you’re right not everyone agrees but we have to look at the totality of the evidence, which Dr. Greger does! Noe has posted studies below that claim the same thing, that high cholesterol isn’t a problem and I explain a bit why that may be incorrect. For example, check out this video on why saturated fat studies are set up to fail.

Yes, this is a recognised association. Just like the association between low cholesterol and cancer, and low cholesterol and total mortality in older people. Similar associations have been found with low weight and mortality etc in older people. Hence the claims that high cholesterol and overweight may be “protective” in older people.

In these latter cases, though, it is believed that the low weight and low cholesterol in older people associated with higher mortality is best explained by “reverse causation”. That is, certain long latency diseases like cancer, some respiratory diseases, viral infections etc cause lower cholesterol. Alzheimer’s Disease is another example of such associations. In these cases, unexplained declining cholesterol levels and weight loss which are not the result of dietary changes (or statins) are most likely early pre-clinical symptoms of disease. People who have stable low weight or low cholesterol throughout life do not have higher mortality or cancer or Alzheimer’s incidence. Ditto for people who have cholesterol lowered by statins.

The fact that people who have lowered cholesterol as a result of statin usage do not have higher stroke risk suggests that this association with stroke may also be an example of reverse causation. This 2009 editorial from “Circulation” offers an interesting discussion of the subject:http://circ.ahajournals.org/content/119/16/2131.full

What about stress?If you need stress hormones the boby must raise cholesterol levels especially ldl otherwise you can t deal with it.If you lower cholesterol while being stressed the danger will be grater.Vegans dont have high cholestrol not becaue they don t eat it but because they are not so biochemically stressed.

Interesting thoughts! We do cover videos on stress so maybe it’s not just diet we need to focus on, but complete lifestyle as stress management is an important lifestyle factor that may also help avoid Alzheimer’s disease. Plus, we know keeping the mind active and busy helps, too.

It appears that one graph in this video (presented at 3:10), from Alzheimer’s & Dementia 7 (2011) 436-444, shows that those with ApoE4 had a slightly DECREASED risk of disease with rising cholesterol, whereas those without ApoE4 had a big increase in disease. But then the conclusion presented doesn’t mention this. Am I reading it wrong? Can anyone elucidate further? Now that we can have our genome analyzed, this kind of information is valuable.

Thank you for this. I lost both of my parents to Alzheimer’s, and they both ate a very high fat diet their entire lives, and even smoked. I don’t think I’ve ever seen them eat a vegetable. I wish I knew then what I know now, maybe they would’ve been around a few years longer.

I can’t help but wonder if an extremely low cholesterol level (not from diet, but from cholesterol lowering drugs) also causes Alzheimer’s symptoms. I witnessed this firsthand with my Mother-in-Law who was prescribed Cholestramine 10 years ago and died recently due to Alzheimer’s like illness, yet ate an incredibly healthy diet. Any research on this U-Shaped relationship of cholesterol levels and dementia prevalence? Thank you!

As for cholesterol and dementia risk, the article below on the U-curve phenomenon generally (it discusses cholesterol among other factors) might be helpful. It notes:
“In a study of 331 very old patients, mean (SD) age 85 (7) years, low BMI, low diastolic blood pressure, low total and HDL cholesterol and high insulin sensitivity predicted total mortality, indicating a “reverse metabolic syndrome” that is probably attributable to malnutrition and/or chronic disorders which have a negative impact on survival [1].”

and concludes:
“The predictive value of the traditional cardiovascular risk factors such as obesity, hypercholesterolemia, hypertension, diabetes and impaired renal function in middle age seems to be reversed in later life describing a U-shaped relationship with survival outcomes. It is likely that the association of malnutrition, inflammation, comorbidities and frailty are the underlying mechanisms of this reverse metabolism in old age (Figure 1).”http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3522512/

Hmm… this is very interesting. Makes sense to me why that MD cured her husband’s alzheimer’s disease with coconut oil. When you apply a finer oil to a thicker fat/grease, it acts as a solvent. Makes sense to me that coconut oil would act as a solvent to cholesterol.

Is YOUR body at or below “room temperature”? Mine isn’t. Mine is 98 degrees F. So coconut oil is liquid in my body – as soon as it hits my mouth. And it’s liquid even on my skin. I’m saying it has to act as a solvent for an animal fat because the molecules in coconut oil are far smaller than the molecules in cholesterol… It’s a simple, mechanical action. Smaller dissolves larger. A solvent phenomenon can occur. Gonzales is a dietician? From what I understand, dietitians are not that well versed in real nutrition – don’t they design the meals that are served in hospitals? No thanks, I won’t be asking a dietitian.

Joseph Gonzales worked for PCRM.org before coming to Nutrition Facts. He has a pretty good grasp of the current science in nutrition. It is up to you whether or not you want to read the article he wrote.

On one hand, this video states “Vascular risk factors, such as high cholesterol, can be thought of as a ticking time bomb to Alzheimer’s Disease”, and also “excess dietary cholesterol could, in principle, contribute to the development of Alzheimer’s disease”.

On the other hand, some professional bodies (in this case, the OPDQ – Quebec’s dietitians association), states that cholesterol is no longer considered a preoccupation for people’s health (that’s my translation from the very last paragraph of the following Written observations dated September 2014 filed by the Association in relation to the federal government’s proposed modifications to nutritional labels). At the last paragraph of page 12 of the following document dated August 2015, the Association reiterates the same point of view, stating that cholesterol should be removed from nutrition labels because it is obsolete information according to the present state of knowledge on lipids that have an impact on blood lipids and cardiovascular risks. To support this point of view, the document provides two sources (footnotes 16 and 17).

I find the Association’s assertion very hard to believe, but maybe there is something I’m not getting.

You’ve got the wrong cholesterol. Nobody has gone back on the idea that high amounts of cholesterol in your blood is a problem. What the OPDQ is saying there is a parroting of America’s DGAC, who said in their 2015 guidelines that eating dietary cholesterol doesn’t have much effect on the amount of cholesterol in your blood and therefore is no longer considered a concern for American diets. As pointed out by Dr. Neal Barnard at the DGAC meetings, this conclusion was made in error

The committee who concluded that misrepresented a report by the American Heart Association and the American College of Cardiology who summarized evidence on nutrients’ effects on lipids and concluded that dietary cholesterol’s effects needed more study. They came to this conclusion by only reviewing evidence published after 1998, which ignores a large period of time when most of the research on dietary cholesterol was conducted, and includes the bulk of modern studies funded by the Egg Nutrition Center that are designed to obscure the relationship. Meta-analysis prior to 1998 had already established that dietary cholesterol does in fact raise blood levels of cholesterol under the right conditions

“These 10 companies are among the largest in the world by a number of
measures. All of them had revenues in the tens of billions of dollars in
2013. Five of these companies had at least $50 billion in assets, while
four had more than $6 billion in profits last year. “

In the last two years I’ve progressed to a plant based whole food diet and I still have quite high cholesterol although the HDL/LDL equation is not too bad. Hypercholesterolemia seems to passed on from my mother who’s taken statins for years. I am trying to avoid taking a statin for the reasons outlined in this video. Any thoughts on managing familial hypercholesterolemia?

I have familial high cholesterol. I noticed a 20% drop when I ate oatmeal daily. That said…
I figure since 100% of my cholesterol is being made by my body I should not worry about it. These numbers are just ways for Doctors to tell us that we need to take prescription drugs. People die from heart disease with great numbers. The numbers are not protective. Eating plant based whole foods without oil is protective. I trust that.
My familial high cholesterol has not resulted in any of my relatives having Alzheimer’s disease.

At 3:10, there’s a graph displaying log odds of AD vs serum cholesterol for e4 and non-e4 alleles of APOE.
1. Do I interpret this right that for APOE-e4 only, higher serum cholesterol is protective?
2. What is the source citation for this graphic?

Yes, I read that paper very carefully. There are 9 mentions of APOE in that paper, but zero stats on cholesterol levels. That paper is not the source of that graphic even though the graph is overlaid on that paper’s abstract.

Here is a link to a fascinating study showing that our old friend, curcumin, binds to amyloid plaques in the retina, such that the plaques fluoresce and are readily visible upon in vivo examination. Several points which I think are interesting: for the in vivo experiment they injected mice intravenously with curcumin since it had already been established that sufficient blood levels could not be achieved with oral turmeric. They also found that plaque formation occurred in the retina earlier in the course of the disease than in the brain. Hence this could serve as a valuable preclinical screening procedure for AD. Probably of greatest significance is the fact if enough curcumin crosses the BBB, it has been shown to remove the plaques.

That info is interesting but three years old and outdated. Here is the abstract from a study published earlier this year using Curqfen. I can’t post a link to the complete study because it is copyrighted.

“The delivery of signiﬁcant concentrations of biologically active free curcuminoids (curcumin, demethoxycurcumin and bisdemethoxycurcumin) at the target tissues has always been regarded as a major limitation for the efﬁcacy of curcumin.Herein we report the blood–brainbarrier permeability, tissue distribution and enhanced bioavailability of free curcuminoids following the oral administration of a food grade curcumin formulation in comparison with the standardized native curcumin, for the ﬁrst time. UPLC-ESI-MS/MS analyses of postadministrationtissuesamplesofWistarrats(200mg/kgbodyweight)demonstratedsigniﬁcant (p < 0.001) enhancement in plasma bioavailability (25-fold),in vivo stability and blood–brainbarrier permeability as evidenced from the tissue distribution of free curcuminoids at, (ng/ g),brain (343 ± 64.7),heart (391.7 ± 102.5),liver (445.52 ± 83),kidney (240.1 ± 47.2),and spleen (229.72 ± 42.2), with extended elimination half-life of 3 to 4 h. Standard curcumin, on the other hand, detected only 1.4 ± 0.8 ng/g of curcumin in the brain tissues."
In essence there was a 300-fold increase in brain levels vs. plain curcumin.

It appears that there are numerous companies that are claiming their formulation of curcumin has the best bioavailability. They all seem to have “studies” to back up their claims. It would be nice if the NutritionFacts team could review the evidence/studies and let us know if the claims are really substantiated. I would really like to know which brand has the “true” best bioavailability.

The study to which I referred is available at sciencedirect.com. There are 8192 PubMed citations for curcumin, Obviously there is enormous interest in this compound. Of those 8000+, 656 have to do with bioavailability.

Many Vegans have Iron levels in their diets comparable to that of meat eaters. Iron is known to be good for the brain. Many women have anemia, an Iron deficiency. Pernicious anemia was once a serious problem in the world. Perhaps it still is in the form of Alzheimer’s, with Iron running out of the brain into the blood and the brain using Phosphorus (Amyaloid plaque) to prop up the brain. That is my opinion, and is not based on the literature. Some have done studies linking dementia to anemia and others have found Iron deposits around brain damage from Alzheimer’s. Is that because the body is putting the Iron there to stop the progression of the disease, or because Iron causes dementia? You can decide. Jeff Bowles wrote a book on how there are some treatments for Alzheimer’s that are effective in extremely small trials or innuendo that will never be funded because they are profitless. These include Melatonin and Lupron (for women). In Dr. Greger’s video, “40 Year Vegan Dies From A Heart Attack,” he states that Vegetarians are 6 times as likely to get Alzheimer’s. Is this not true? Is this because of the B12 deficiency issue? Here we see that low Cholesterol can prevent the disease. Lysine and Niacin can remove Cholesterol from the blood. Niacin can defend against Alzheimer’s, possibly because Niacin can remove Cholesterol from the blood. http://www.ncbi.nlm.nih.gov/pubmed/15258207 I would love to know if the Vegetarian diet can defend against Alzheimer’s, perhaps given a good supply of Iron rich foods like Pumpkin seeds.

Yep, lets drop that silly cholesterol concern from the dietary guidelines! We all know it’s only those vegetarians with their radical plant based agenda who believe eating the animal products containing it is an issue anyway! No “normal” person would even consider that the animals you eat will eat you in the end…in an equally horrific way!

Off topic: Last night we saw Dr. Roizen on his latest PBS special. This led us to look up some of his videos, not having seen him since he and Dr. Oz were on Oprah. We watched a video on purified Omega 7, something he takes daily. Omega 7?? Some of his comments on the TV special were apparently behind the times (saying to avoid all artificial sweeteners —blue, yellow or pink packages– that led us to think he did not know about erythritol nor did he comment on Stevia. So! has anyone an educated overview of the importance of Omega 7?

I assume he means palmitoleic acid, which is a non essential monounsaturated fat. I did have to look it up though. I cannot provide much more than that, I really don’t know. I am highly doubtful there is any health benefit from its consumption.

Why is it that the medical community is so clueless about the value of eating a plant-based whole foods diet? Yearly I talk with my MD, dentist, eye doc, etc. and they just smile, like I’m 8 years old or senile. They seem to ignore all of the information that’s now available. I try to be a walking billboard for our movement, one in great heath, on no meds, and with excellent blood results at age 66.

Unless one goes to functional/integrative medical practitioners, a person can pretty much count on their physicians knowing next-to-nothing about nutritional research and acting condescendingly, just as you described, Emily in MT. When I turned up with osteopenia, I had to ask my GP to test my vitamin D levels. He complied but I had to initiate getting the test. Sure enough, I was in the low 20’s. When my levels weren’t rising, even with supplementation, I had to be the one to do the research as to why: the literature from Vitamin D Council and NF.org quickly informed me that my doctor’s recommended supplementation level was way too low; I wasn’t taking the pill with a meal; I am overweight and thus needed a higher dose; at my city’s latitude, absorption via skin exposure is limited. Repeat performance when I suffered a leg fracture: the orthopedist made no dietary recommendations, did not recommend a vitamin D test, etc. I went into high drive and figured out what I needed to do to maximize my bone healing. Fortunately, my osteopenic bone healed very well and I attribute that to my intensive research and self-prescribed treatments. (Sadly, there is not a single functional/integrative physician on my big HMO plan.)

I wonder too, and also experience the “yes, that’s nice dearie” disbelief/denial reaction regularly. Infuriating! My doctor (who I had to see monthly when I was on a slew of her medications and diabetic) has taken to having her staff call to remind me I “need” to come in for an appointment! (Because apparently my WFPB diet, that she dismissed, worked TOO well?) LOL

I have multiple sclerosis and familial hypercholesterolemia. This video made me think of my LDL causing the plaques in my brain that indicate MS. Is that connection being looked at? I had pretty severe short term memory problems which have resolved. The problems were when I was on Lipitor, a popular statin, and have resolved quite a bit now, when I am no longer taking Lipitor. I did not know the connection and do not know if the problem is that straight forward.

Thank you, I did not hear that it was only a Vitamin D deficiency. Dr Swank who is one of Dr John McDougall’s mentors says it is caused by our fatty diet. At least he says it is activated by more than 19 grams of fat in one day. I keep my fat intake to %10 or less by eating whole foods, starch based and vegan. I also avoid things like cocoanut, avocados nuts, seeds and tofu which are high fat foods. Once I lose my excess weight I will add some of those foods back, keeping the fat grams per day in check to avoid activating my MS.
MS is more common the farther a population is from the equator, probably because as one goes farther from the equator, plant food is less available. My MS is well controlled on this diet. I still have heat intolerance but most of my symptoms are minor on a truly low fat diet.

He had patients who got up from wheel chairs after only two weeks on his program, according to “Orthomolecular Medicine for Everyone.”

“Recently I (A.H.) witnessed the full recovery of a man with MS after one year of Orthomolecular nutritional treatment, which included 12,000 IU per day of Vitamin D3. The MS lesions in his brain cleared completely and he remains well.”

Orthomolecular Medicine for Everyone. Hoffer and Saul (2008).

A cure for MS in D3 is real. Doctors who recommend D3 for MS are shunned and ignored. D3 is a curative factor in almost all non-injurious diseases.

“A group of young patients having multiple sclerosis was treated with dietary supplements containing calcium, magnesium and vitamin D for a period of one to two years. The experimental design employed self-pairing: the response of each patient was compared with his/her own case history as control. The number of exacerbations observed during the program was less than one half the number expected from case histories. No side effects were apparent. The dietary regimen may offer a new means of controlling the exacerbation rate in MS, at least for younger patients. The results tend to support a theory of MS which states that calcium and magnesium are important in the development, structure and stability of myelin.”
I take 30,000 IU of D3 daily. Are you taking your D3 supplement? Any danger from D3 is greatly exaggerated.

I just read the linked article about the Cause of MS. Very interesting. I took Thyroxin when I was a teenager. The mention of lack of iodine and subsequent thyroid disfunction was new information. I did not know low thyroid function and MS were associated. I do have low levels of Vitamin D too so this article is linking to my personal history well. I also have not heard of Roger MacDougall and his MS diet. Thank you for the link.

Be very careful when you take Iodine. One of the side effects of too much Iodine is a “weak pulse.” I took some Iodine and can no longer feel my heartbeat. It’s a thrill. It’s like Joy all day. Make sure you watch your stomach, you can see your pulse there, because taking any amount of Iodine can cause you to no longer feel your heartbeat. It’s still there though. After taking some Iodine within twenty minutes you might not feel your heart beating in your chest. I hope that you are in good hands. Choosing to take Iodine is the beginning of a big journey for you. You have my best wishes. Iodine can profoundly normalize your heartbeat. I have had two EKGs since I took Iodine, both of which show I have a very normal heartbeat. I believe in you. I know you are loved. You are the best.

Very interesting read on this board. I thought I was in a fairly tale land what without the uninformed people trying to act intelligent and spending most of the time deriding what someone else said. Who knew there was actually a civilized forum on the net? Thanks guys for the read, I’ll be back…John

Side effects to statins are common, and dementia is only one!!! DB,
muscle damage, etc. Statins do not prolong life, in women they shorted
life span……. They are however, most profitable for big pharma. You
can not believe the drug company sponsored studies sited in this video
and I am so disappointed and disgusted that they are used here….Dr G
should know better…… They are designed with predetermined
conclusions and created to sell drugs.
There are plenty of
independent studies that show that cholesterol does NOT cause heart
disease. Why do the French have low levels of heart disease (and smoke)
and higher cholesterol levels??? eat butter, cream, etc? Because
……it is extremely important for your bones and arteries to get
adequate fat soluble vitamins to assure that calcium goes into bone and
NOT your arteries. These FAT soluble vitamins, which need fat for
proper absorption, are Vitamin K2, D, A and E. The most important one
we are missing K2, is found in ANIMAL products like grass fed
butter and eggs, goose liver pate, , gouda and brie cheeses, or natto
fermented soybeans…good luck finding natto here in the USA!
Dr G
needs to take a break from his anti cholesterol rants and wake up to
what is really going on in our arteries. VITAMIN K2 and fat soluble
vitamin deficiency. See the book Vitamin K2 and the Calcium Paradox by
Kate Rheaumen-Bleue, the article on Dr. Mercola’s website and do a
little googling to find out more about K2, discovered by Dr Weston Price.

Search the site from time to time when you have questions. You may find that material is present to help answer the question precisely because the questions are of great interest to the site’s audience in general, and NF has been in operation for a considerable period of time.

The Hopkins meta analysis referred to in Dr Greger’s video cited by largelytrue also notes that:
“Serum cholesterol concentration is clearly increased by added dietary cholesterol but the magnitude of predicted change is
modulated by baseline dietary cholesterol. The greatest response is expected when baseline dietary cholesterol is near zero, while
little, if any, measurable change would be expected once baseline dietary cholesterol was > 400-500 mg/d.”http://ajcn.nutrition.org/content/55/6/1060.full.pdf+html

In other words, if like most Westerners your baseline cholesterol is already high, added dietary cholesterol will have little if any effect.

Very interesting! The Alzheimer risk for a person with familial hypercholesterolemia seems quite unfavourable then. A plant based whole food diet is not bringing the cholesterol levels enough down to get a favourable ratio, and one is thus dependent on statin drugs for the rest of ones life – vegan or not. Do you know if any studies have examined this link, i.e. familial hypercholesterolemia + vegan diet vs. familial hypercholesterolemia + statins, on Alzheimer risk?

Hi Dr. Greger, Per your request I am posting this question here: Earlier this year I lost my dear Dad to ALS (motor neuron disease) and I keep wondering if it may have had something to do with his high cholesterol (he was sadly ‘sold’ on the benefits of coconut oil, despite my warnings). The above video on high cholesterol and dementia/Alzheimers, makes me wonder if you have ever seen any research linking high cholesterol to ALS/MND. I also saw the videos linking BMAA to some instances of ALS but wondered if there had been any other research on high cholesterol, plaque formation, and motor neuron function. Thanks again for your amazing work!

Earlier this year I lost my dear Dad to ALS (motor neuron disease) and I keep wondering if it may have had something to do with his high cholesterol (he was sadly ‘sold’ on the benefits of coconut oil, despite my warnings). I recall your videos on high cholesterol and dementia/Alzheimers, and wondered if you have ever seen any research linking high cholesterol to ALS/MND. I also saw the videos linking BMAA to some instances of ALS but wondered if there had been any other research on high cholesterol, plaque formation, and motor neuron function. Thanks again for your amazing work!

Could you comment on the Finnish study discussed in the NY Times on 2/23/16 that followed healthy men for 21 years and found no association between cardiovascular disease and total cholesterol or egg consumption?

Since I eat a fair amount of saturated fat from coconut oil and organic palm shortening, and I usually mix both with nuts (raw nuts but I bake with palm shortening so they aren’t raw anymore :-), am I risking creating Alzheimers by mixing sat fat and high copper foods? Are you just referring to sat fats from meats (as they metabolize differently and trigger unfavorable prostaglandins) or are my plant fats a problem when mixed with copper rich nuts?

I just watched the video on the NutritionFacts.org YouTube page about Alzheimer’s disease and copper. My father wears a copper bracelet that he has worn for many years to help with joint pain. Do you think this could contribute to Alzheimer’s disease? Thank you!

I know this has nothing to do with Alzheimer’s but there was no post about it…
My brother was diagnosed with schizophrenia. As a big believer of a low fat (high raw) vegan diet, I was wondering if there are studies that show the connection of food and schizophrenia. Is a healthier diet and lifestyle helping with schizophrenia? I know that drug addictions do take an important role in the therapy of schizophrenia, so I thought food could too? Thank you

I’m sorry to hear about your brother’s condition. Unfortunately, there is very little high quality research on the effects of diet on the development and treatment of schizophrenia. However, given a WFPB diet is known to be good for the brain (as this video and others on this site demonstrate) I would speculate that such a diet would at least maximize the degree of health someone with this condition can have.

What is very well known is that those that suffer from schizophrenia and other mental illnesses are at higher risk than the general population for cardiometabolic diseases, such as high blood pressure, metabolic syndrome, heart disease, etc. This is likely due to multiple risk factors, such as a higher rate of smoking, medication side effects and poor diet, among others. We know a WFPB diet will help prevent cardiovascular disease. Therefore, even if this diet doesn’t prevent schizophrenia, it can certainly help minimize the negative health consequences.

Having eaten an almost exclusively plant-based (5-10 meals with wild venison/year) diet for 5 years, my total cholesterol still runs around 230-240 with a mediocre LDL/HDL ratio. I eat sugar, though not massive amounts and enjoy our local IPA beers, a cocktail and wine regularly, though not to excess (about 1-2 drinks/day average.) I don’t want to use statins as my doctor suggests. Have any of you had similar experience with blood profiles and made significant improvements? Love to hear from you.

incaseyouwondered: Most people who switch to a plant based diet experience a great lowering of cholesterol. However, some people’s bodies are stubborn. I answered a similar question some time ago with some speculation/ideas to consider. Maybe it will help you too. I’m not an expert, so consider that when reviewing the ideas below.
.
******************************
1) Is your weight ideal? Someone who is overweight may have cholesterol problems just from that situation. I first learned this from Tom Goff who wrote: “There is an interesting article on being overweight and its effects on lipids like cholesterol. It is quite technical but it concludes: “diets low in saturated fat and cholesterol are less effective in the obese. The most effective way for obese people to normalize their blood lipids is to lose weight”. http://www.ncbi.nlm.nih.gov/pubmed/16256004 . It is therefore possible that your system and metabolic response to eating a healthy diet won’t result in optimal cholesterol numbers until you are in a healthy weight range.”
.
A lot of people lose weight switching to a vegan diet, but not everyone losses any or all of the excess weight. I can give you some great advice for lowering your weight the healthy way if you are interested.
.
2) Do you have genes that just keep you with extra high cholesterol? I believe it is called familial hypercholesterolemia. If you do have this situation and if your diet is mostly whole, low fat plant foods, then maybe you don’t need to worry about your cholesterol levels? I don’t know that we have any data on people who have been eating a low fat whole plant food diet for many years an yet their cholesterol is still too high. But I heard Dr. Klaper once say to not worry about it. He thinks that if you are eating the right diet, then you cholesterol won’t oxidize and you won’t get a heart attack. (Assuming I understood him correctly.) I don’t know if Dr. Klaper has hard data on this assertion, but it makes sense to me. I believe you can do tests to figure out what your genes are regarding familial hypercholesterolemia??
.
3) Do you eat a lot of fatty plant food? I was listening to a lecture recently from Dr. Jim Bennie and he told a story about a patient who was vegan for a while, but who still had high cholesterol. It turns out that that person was eating multiple avocados a day. To be optimally healthy, I think you need to go low-fat, not just whole plant foods. So, moderate your intake of avocados and nuts and skip the oils (olive oil, coconut oil, cocoa butter, Natural Balance etc.)
.
4) Were you eating a less than ideal diet for many years before becoming vegan? It seems (to my lay person’s brain), that some people’s bodies are all messed up after eating a bad diet for decades. So, my theory is that just switching to a vegan diet is not necessarily going to get your body to stop producing massive amounts of cholesterol. Or maybe your body produces more for a bit to compensate for the change in diet?
.
Whether my theory is correct or not, it may be necessary to adopt a diet especially dedicated to lowering cholesterol. This would mean not only following the general basic Whole Plant Food Based diet that applies to most everyone, but also includes incorporating those foods which have been specifically shown to lower cholesterol. The last paragraph on the topic page for cholesterol on NutritionFacts includes this list of foods along with links to the details: http://nutritionfacts.org/topics/cholesterol/ (This page is well worth checking out anyway as a great summary of the information about cholesterol in general.)
.
And then, if that doesn’t help, I like to refer people to Joseph’s excellent advice on what to do if you have tried everything and you still can’t lower your cholesterol: (Joseph was an RD who used to be part of the NutritionFacts staff) “What can I do to lower my cholesterol? It seems I’ve tried everything!” http://nutritionfacts.org/questions/what-can-i-do-to-lower-my-cholesterol-it-seems-ive-tried-everything/
.
Hopefully some of those ideas will help.

I have high cholesterol that I can’t get below 250 (total cholesterol) despite the healthy plant-based diet that I have been on for over 2 years, and daily exercise consistently every day. My doctor says that it is hereditary and being produced by my body and is not due to my diet, and recommends that I take a statin drug. I am very resistant due to all the side-effects that I’ve read about and he has even threatened to no longer be my doctor if I don’t follow his advise. I am 66 and take no prescription medications at all. What should I do?

kewlgeek: I’m sorry to hear about your dilemma. In the end, it is your decision. It is your doctor’s place to tell you all the options, including their risks and benefits. And then it is up to you to make a decision based on your values. It sounds like your doctor does not understand his/her basic duties. How much do you think this doctor is worth staying with? Does this doctor provide more value than harm?
.
One option is to do a phone consultation with Dr. Michael Klaper. Dr. Klaper is a plant-based doctor who has a lot of experience in the area of heart disease. You could at least get a second opinion with him. You could ask him hard questions and see what you think of the answers. He may also have recommendations for other doctors in your area if you feel that you need someone who understands his duties better.
.
Good luck.

Hi Mii–check out the other videos on this site about Alzheimer’s disease: Alzheimer’s Disease videos. You may be particularly interested on the one called Treating Alzheimer’s Disease with Tumeric. Although there is no good evidence that dietary changes can cure Alzheimer’s, it seems some dietary changes may help slow the progression.

I’ve recently (2 months) switched to a plant based diet and feel great and great about it. For quite a few years have been on Lipitor for slightly elevated cholesterol (220 on no meds but not too good a diet at the time). After a recent 6 month regular blood workup one of my numbers (Alkaline Phos) was slightly elevated and got me to thinking with the new diet I want to back off the statin and just try keeping the cholesterol down with the new Plant based diet. Currently my cholesterol is 135. LDL is 47 which are great numbers and I even believe the new diet has much augmented the statin. I think I can keep my cholesterol within good numbers without the statin and it’s potential health risks. My question is .. is there a danger to stopping the Lipitor cold turkey all at once? I’m 59, a former boxer still in good shape and otherwise extremely healthy. Just worried about the longtime statin use and any potential risk of stopping it abruptly.

alvanwel: Why do you think your cholesterol levels are too low? It’s my understanding that cholesterol levels cannot get too low just based on a change in diet. It sounds like your levels are getting to a healthy level for yourself.

Pick’s Disease prevention ?? I am sitting here in the room with my father (age74) at his long term care facility hoping he will sleep more than wake tonight. Since 2011 we have been living with what we thought was Alzhiemers. My fathers extremely intelligent doctor has recently added the diagnosis of Pick’s Disease due to my fathers behaviors , the earlier onset, and the fact he lost most of his mobility. My question is – I’ve been very encouraged that a whole foods plant based diet could spare me (and my children) much of the agony of Alzheimer’s but can it spare me from Pick’s ? Or at the very least delay it – the life we are living right now terrifies me for the future. Thank you for any help or reassurance.

Thank you for your reply and the information . I think the mission you all are working towards at NF is so critically important. Being in the long term care facility a lot it does encourage you to want to be a healthier older person no matter what you end up facing. I am grateful for intelligent medical staff and that we have answers just looking for hope. Thank you so much ! -Amy

Ingrid: To my knowledge, it is not possible to get too little cholesterol through eating a healthy diet. In other words, your body produces all the cholesterol it needs. The problem comes when we eat foods that cause our bodies to produce too much cholesterol. When we stop eating those bad foods, our bodies (hopefully!) drop production back to human-normal, healthy levels. Our bodies do not go below healthy levels just because of a diet change. You might also check out the following NutritionFacts video: http://nutritionfacts.org/video/can-cholesterol-be-too-low/

There are some people who will tell you that “low” cholesterol levels cause this or that problem. However, when the matter is investigated, it turns out to be a situation of reverse causation. For example, some cancers cause low cholesterol levels and cancer causes death. That does not mean that low cholesterol levels cause death… See what I mean?

I’m wondering how the distinction between “good” and “bad” cholesterol applies to the relationship between cholesterol and Alzheimer’s Disease? My total cholesterol is 273, (LDL 101, HDL 120, Triglycerides 78). I’m always told by physicians that my risk factor is low for heart disease because of the high HDL. My understanding is that LDL is the important measurement regarding heart disease, and that it should be lowered to between 50 and 70 through eating a WFPB diet, and that will probably only be possible once I reach my ideal weight (that pesky 10 lbs). I’m working on that, but this connection between cholesterol and Alzheimer’s has my attention. Is Total Cholesterol the issue, and I need to worry about HDL, or do I continue to focus on LDL?

Do deaf or hard-hearing people tend to suffer alzheimer desease? A Japanese company just aired a TV show about
alzheimer, and they said those kind of people are likely to become alzheimer because they tend to get less or no
acoustic signals, which excite their brains. In the study that they are making thier claim based on, they picked random
individuals and discovered that among deaf or hard hearing people the risk of alzheimer was higher than normal folks
without testing their diet at all so I think this is nowhere near either acurate or reliable.

I READ IN “The Grain Brain” Dr. Pelm utter states that low cholesterol levels causee dementia. Yet I seem to have missed where he got this information. Do you have any proof of this? What is your view on this? I also know fromyour book, that I own and love, that at least 2 ways of getting good cholesterol is from avocados and nuts.

Since as you say in your blog, Nigerians have the highest frequency of the Alzheimer’s gene ApoE4 but some of the lowest rates, because they eat mainly grains and veggies, do you think that’s a reason to reduce nut/seed consumption down to say one or two tablespoons daily? I brought my total cholesterol down to 204 from 297 with a whole foods/plant-based diet but my LDL is still borderline high at 133 (my lowest ever). Do you think reducing nuts and fruit, to eat more like the Nigerians, would help? I tend not to eat grains at all but eat a lot of fruit.

If you want to control your cholesterol levels, in order to prevent coronary heart disease or reduce the risk of Alzheimer’s disease, you don’t need to cut your nut consumption, as the type of fats in these food groups are the ones called “beneficial”

Yes, that’s what I’d read on this site though I had a correspondence with vegan author Brenda Davis and she thought in my case, maybe I should limit all saturated fats, even nuts. I went vegan 7 years ago and never have food with cholesterol. I’ve done all I can except trying grains. So I’ll try that! Thanks!

I am 60 years old and my total cholesterol has almost always been high (most recently 243). I am an endurance athlete so my doctor has indicated this is not a concern. This recent test showed triglycerides = 43, VLDL = 9, LDL = 96, and HDL = 138. I listened to the video on the relationship of cholesterol and alzheimer’s disease. Should I be concerned?

JohnLM,
If you are eating a diet high in saturated fats and pro-inflammatory foods such as animal products and processed foods, then, yes, you should be concerned. Its not just the cholesterol numbers that are of concern. Alzheimer is also linked to glycoproteins and inflammation. Check out some of the other videos on Alzheimers. https://nutritionfacts.org/topics/alzheimers-disease/
Even though you exercise considerable, which is great, its equally important that you are supporting the demands on your body with the appropriate fuel, complex carbohydrates.The best insurance against Alzheimer is lifestyle choices with WFPB eating. You may already being doing this, but I just want to make sure you are looking at the whole picture of lifestyle.

The page you sent me to essentially concludes “any cholesterol level is bad” with respect to alzheimer’s. I can’t seem to find anything that discusses what two MDs told me — that is, with high HDL (138), don’t worry about high total cholesterol (243). To be fair, they were talking in general terms, not related to alzheimer’s specifically. I recently completed a specialized diet addressing chronic symptoms of “leaky gut”, it was successful. And yes, I bought Greger’s How Not to Die cookbook and am switching from the leaky gut diet in favor of his WFPB diet, but I’m still unsure about how much of a crisis my total cholesterol is. If I am strict about Greger’s diet and get my blood tested again in six months, can I expect to see significant improvement in my total cholesterol? I’m encouraged by what I read on the linked page you shared about cumulative effect and potential reversal but am unsure whether this will be enough?

JohnLM,
You ask some very good questions. We have no way of knowing precisely how your cholesterol levels will respond to following Dr. G’s recommendations, especially since we do not know exactly what you have been eating. My guess based on experience and the data is that you will see improvements.

In addition to improving your labs, eating WFPB will give you the antioxidants and phytonutrients to minimize oxidation and inflammation. We look forward to hearing back from you after implementation of Dr. G’s recommendations.

Hi Joy. Thanks for the link, it is informative about oxidized cholesterol, but it leaves a few questions. First, how does one know their LDL is oxidized, is there a test for that? Second, what is the connection with Alzheimer’s? I see discussion in this article relative to cancer, diabetes, and heart disease; but it makes no mention relative to Alzheimer’s Disease. Finally, does the presence of HDL negate or mitigate the presence of oxidative LDL; if so, how? Thanks.